EP1589906B1 - Implant de remplacement vertebral - Google Patents

Implant de remplacement vertebral Download PDF

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Publication number
EP1589906B1
EP1589906B1 EP04708377A EP04708377A EP1589906B1 EP 1589906 B1 EP1589906 B1 EP 1589906B1 EP 04708377 A EP04708377 A EP 04708377A EP 04708377 A EP04708377 A EP 04708377A EP 1589906 B1 EP1589906 B1 EP 1589906B1
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EP
European Patent Office
Prior art keywords
elements
male
female
rotation
guided
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Expired - Lifetime
Application number
EP04708377A
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German (de)
English (en)
Other versions
EP1589906A2 (fr
Inventor
Richard Assaker
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ScientX SA
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ScientX SA
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Publication date
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Publication of EP1589906A2 publication Critical patent/EP1589906A2/fr
Application granted granted Critical
Publication of EP1589906B1 publication Critical patent/EP1589906B1/fr
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Expired - Lifetime legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/46—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor
    • A61F2/4603—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof
    • A61F2/4611—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for insertion or extraction of endoprosthetic joints or of accessories thereof of spinal prostheses
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A—HUMAN NECESSITIES
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/4637—Special tools or methods for implanting or extracting artificial joints, accessories, bone grafts or substitutes, or particular adaptations therefor for connecting or disconnecting two parts of a prosthesis
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
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    • A61F2/44—Joints for the spine, e.g. vertebrae, spinal discs
    • A61F2/4455—Joints for the spine, e.g. vertebrae, spinal discs for the fusion of spinal bodies, e.g. intervertebral fusion of adjacent spinal bodies, e.g. fusion cages
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    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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    • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30484—Mechanically expandable devices located on the first prosthetic part for locking into or onto the second prosthetic part
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    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30487—Circumferential cooperating grooves and beads on cooperating lateral surfaces of a mainly longitudinal connection
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    • A61F2002/30476—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism
    • A61F2002/30507—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements locked by an additional locking mechanism using a threaded locking member, e.g. a locking screw or a set screw
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Definitions

  • the present invention relates to a medical implant for replacing, at least partially, a vertebra in order to maintain the normal spacing between the adjacent vertebrae.
  • the subject of the invention finds application for vertebral replacement at the cervical, thoracic or lumbar level.
  • a replacement implant also called corporectomy implant.
  • corporectomy implant also called corporectomy implant.
  • the patent application FR 2,730,158 describes a replacement implant comprising two hollow elements nestable one inside the other and having at their mutually opposite face, complementary shapes cooperating with each other to allow the distraction movement of the elements while avoiding their displacement in compression.
  • Such a replacement implant makes it possible to adjust in situ the length of the implant by ensuring the relative spacing between the two elements by sliding to their final locking position.
  • Such an implant thus has an irreversible blocking prohibiting a possibility of retraction, which is a major drawback in certain installation conditions.
  • the object of the invention is to overcome the disadvantages of the prior art by proposing a vertebral replacement implant designed to allow to be adjusted in length in situ while allowing to pass in a simple, fast and reversible manner. a length adjustment position at a locking position.
  • the document US 2002/082696 discloses a vertebral replacement implant having two male and female hollow members slidably mounted relative to each other.
  • This implant comprises means ensuring the blocking and the free sliding of the elements between them.
  • These locking means comprise a series of indentations arranged on a longitudinal portion of the male element while the female element comprises a threaded receiving hole for a locking screw adapted to cooperate with the indentations.
  • the vertebral replacement implant is in accordance with claim 1.
  • each male and female element is provided with an end wall intended to cooperate with a vertebral plateau.
  • Another object of the invention is to provide a replacement implant for optimizing the contact between at least one of the end walls of the implant and the vertebral plateau.
  • at least one end wall is equipped with a sagittal plane inclination system.
  • the tilting system is of the screw-nut type and comprises a threaded rod guided in rotation and locked in translation to cooperate with a threaded ring locked in rotation and connected to the end wall guided in inclination.
  • the threaded rod extends diametrically inside an element and comprises means for receiving a control instrument accessible from outside the element.
  • the Fig. 2 is a sectional elevation view showing the vertebral implant in a locking position.
  • the Fig. 3 is a partial view in elevation section showing the implant in free sliding position of the elements between them.
  • the male 2 and female 3 elements are slidably mounted relative to each other along their longitudinal common axis X.
  • the sliding assembly between the male and female elements 2 3 is produced by means of a guide stopper 5 equipping the male element 2 and engaged in an open slot 6 arranged on the female element 3 in a longitudinal direction parallel to the longitudinal axis X.
  • the replacement implant 1 comprises means 8 ensuring on the one hand, the free sliding of the elements 2, 3 between them and on the other hand, their relative locking.
  • These locking means 8 comprise on one of the elements namely the female element 3 in the illustrated example, an anchoring surface 10 arranged on a longitudinal portion 11 of the wall.
  • This anchoring surface 10 extends inside the wall of the female element 3 vis-à-vis an anchor pad 12 mounted on the other element, namely the male element 2 in the illustrated example.
  • the anchor pad 12 is guided in translation to occupy a first position in which the male 2 and female 3 elements can slide freely between them ( Fig. 3 ) and a second position in which the anchor pad 12 cooperates with the anchoring surface 10 to block the elements 2, 3 in position between them ( Fig.
  • the anchor pad 12 has on its transverse face extending perpendicularly to the direction of translation of the pad, a form of anchoring complementary or conjugate to the anchoring surface 10 so that in mutual cooperation, the elements 2, 3 are locked in position.
  • the anchor pad 12 and the anchor surface 10 have teeth extending transversely to the sliding direction of the anchor pad 12.
  • the locking means 8 also comprise a system 15 for transforming a rotational movement into a translation movement which is transmitted to the anchor pad 12 so that it occupies its unobstructed position or its position of cooperation with the anchoring surface 10.
  • the transformation system 15 is equipped with means 16 for receiving a not shown instrument, adapted to rotate the system 15 in two opposite directions.
  • the anchor pad 12 is able to occupy one of its two characteristic positions.
  • the transformation system 15 is of the screw-nut type.
  • the transformation system 15 comprises an axis 17 guided in rotation and locked in translation and mounted to extend diametrically inside the male element 2, in its remaining part still engaged in the female element.
  • the shaft 17 has a first end 18 of circular cross section mounted with clearance, in a bore 19 formed in the wall of the male element 2.
  • the first end 18 is bordered on one side by a shoulder 21 and the other side by the stop 5.
  • the axis 17 is thus locked in translation by the stop 5 and the shoulder 21, while being guided in rotation.
  • the first end 18 of the axis 17 is provided with the receiving means 16 of the control instrument in rotation of the axis.
  • the receiving means 16 is formed by a hole of prismatic section arranged on the transverse face delimiting the first end of the axis 17.
  • the hole 16 opens in the opening lumen 6 opening on the external face of the female element 3 so that the hole 16 can be accessible from outside the implant using a control instrument such as a screwdriver for example.
  • the shaft 17 is provided with a threaded portion 25 cooperating with a tapping 26 presented by the anchor pad 12 which is guided in translation and locked in rotation.
  • the second end 27 of the axis 17 opposite the first end 18, is provided with the threaded portion 25.
  • the anchor pad 12 has a prismatic outer shape mounted inside a bore 28 of similar section formed in the wall of the male element 2 thus ensuring a translation guide and the locking in rotation of the pad of anchoring 12.
  • the rotation of the axis 17 in one direction allows the sliding of the anchor pad 12 to bring it closer to the anchoring surface 10 while the rotation of the axis 17 in an opposite direction leads to move the anchoring pad 12 in translation relative to the anchoring surface 10.
  • the threaded rod 31 is provided at one end with a head 34 passing through a passage 35 the wall of the male element 2.
  • the other end of the threaded rod 31 is equipped with a translational stop 37.
  • the threaded rod 31 cooperates with the threaded ring 32 which is provided on either side of extensions 32 1 engaged in complementary holes formed in tabs 40 extending at right angles from the end wall 2 a .
  • the end wall 28 is supported by a plate 42 extending from the body of the male element 2 and delimiting by its upper edge a rotating guide cradle for the wall end 2 a .
  • the end wall 28 has a convex inner face adapted to cooperate with the plate 42 of concave shape.
  • the intervertebral implant 1 is adapted to provide simple and effective sliding movement of the male 2 and female 3 elements .
  • each male 2 and female 3 element comprises zones 50 for gripping apparatus providing relative sliding between the male 2 and female 3 elements .
  • These gripping zones 50 are formed on each element by two flats extending diametrically opposite on the male 2 and female 3 elements .

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Transplantation (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Cardiology (AREA)
  • Vascular Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Physical Education & Sports Medicine (AREA)
  • Neurology (AREA)
  • Prostheses (AREA)

Abstract

L'objet de l'invention concerne un implant de remplacement vertébral comportant : deux éléments longitudinaux montés coulissant l'un par rapport à l'autre, et des moyens (8) de blocage comportant : - sur l'un des éléments, une surface d'ancrage (10), et sur l'autre des éléments : un patin d'ancrage guidé (12) en translation pour occuper une première position dans laquelle les éléments coulissent librement entre eux et une deuxième position dans laquelle le patin d'ancrage (12) coopère avec la surface d'ancrage (10) pour bloquer les éléments entre eux, un système (15) de transformation d'un mouvement de rotation en un mouvement de translation transmis au patin d'ancrage (12).

Description

  • La présente invention concerne un implant médical destiné à remplacer, au moins partiellement, une vertèbre en vue de maintenir l'écartement normal entre les vertèbres adjacentes.
  • L'objet de l'invention trouve une application pour le remplacement vertébral au niveau cervical, thoracique ou lombaire.
  • Dans l'état de la technique, il est connu diverses variantes de réalisation d'un implant de remplacement appelé également implant de corporectomie. Par exemple, la demande de brevet FR 2 730 158 décrit un implant de remplacement comprenant deux éléments creux emboîtables l'un dans l'autre et présentant au niveau de leur face mutuellement en regard, des formes complémentaires coopérant entre elles pour permettre le déplacement en distraction des éléments tout en évitant leur déplacement en compression.
  • Un tel implant de remplacement permet de pouvoir régler in situ la longueur de .. l'implant en assurant l'écartement relatif entre les deux éléments par coulissement jusqu'à leur position définitive de blocage. Un tel implant possède ainsi un blocage irréversible interdisant une possibilité de rétraction, ce qui constitue un inconvénient majeur dans certaines conditions de mise en place.
  • Le document WO 00/23 013 décrit un implant de remplacement comportant deux éléments longitudinaux creux mâle et femelle montés coulissants l'un par rapport à l'autre. Cet implant de remplacement comporte une bague de couplage destinée à occuper une première position de non-coopération avec un moyen complémentaire de couplage pour autoriser un libre coulissement des éléments entre eux, et une deuxième position de coopération avec le moyen complémentaire de couplage pour assurer un blocage des éléments entre eux. L'inconvénient principal d'un tel implant de remplacement a trait à la difficulté de commander en rotation la bague de couplage pour passer d'une position à l'autre.
  • L'objet de l'invention vise à remédier aux inconvénients de l'art antérieur en proposant un implant de remplacement vertébral conçu pour permettre d'être réglé en longueur in situ tout en permettant de passer d'une manière simple, rapide et réversible d'une position de réglage en longueur à une position de blocage.
  • Le document US 2002/082696 décrit un implant de remplacement vertébral comportant deux éléments creux mâle et femelle montés coulissants l'un par rapport à l'autre. Cet implant comporte des moyens assurant le blocage et le libre coulissement des éléments entre eux. Ces moyens de blocage comportent une série d'indentations aménagée sur une partie longitudinale de l'élément mâle tandis que l'élément femelle comporte un trou taraudé de réception pour une vis de blocage adaptée pour coopérer avec les indentations.
  • Pour atteindre un tel objectif, l'implant de remplacement vertébral est conforme à la revendication 1.
  • Avantageusement, l'axe s'étend diamétralement à l'intérieur de l'élément mâle et comporte :
    • une première extrémité pourvue du moyen de réception de l'instrument de commande, cette première extrémité étant guidée en rotation et bloquée en translation dans une paroi de l'élément mâle,
    • une deuxième extrémité munie de la partie filetée coopérant avec le taraudage du patin d'ancrage qui est guidé en translation et bloqué en rotation dans la paroi opposée de l'élément mâle.
  • Avantageusement, le moyen de réception de l'instrument de commande débouche dans une lumière aménagée dans une paroi de l'élément femelle pour être accessible de l'extérieur de l'implant, la paroi de l'élément femelle étant munie intérieurement dans sa partie opposée de celle pourvue de la lumière, de la surface d'ancrage.
  • De préférence, chaque élément mâle et femelle est pourvu d'une paroi d'extrémité destinée à coopérer avec un plateau vertébral.
  • Un autre objet de l'invention est de proposer un implant de remplacement permettant d'optimiser le contact entre au moins une des parois d'extrémité de l'implant et le plateau vertébral. Pour atteindre un tel objectif, au moins une paroi d'extrémité est équipée d'un système d'inclinaison dans le plan sagittal.
  • Avantageusement, le système d'inclinaison est du type vis-écrou et comporte une tige filetée guidée en rotation et bloquée en translation pour coopérer avec une bague taraudée bloquée en rotation et reliée à la paroi d'extrémité guidée en inclinaison.
  • Avantageusement, la tige filetée s'étend diamétralement à l'intérieur d'un élément et comporte un moyen de réception d'un instrument de commande accessible de l'extérieur de l'élément.
  • Avantageusement, le dispositif anti-retour est débrayable autorisant le mouvement selon un sens de rapprochement des éléments mâle et femelle.
  • Diverses autres caractéristiques ressortent de la description faite ci-dessous en référence aux dessins annexés qui montrent, à titre d'exemples non limitatifs, des formes de réalisation de l'objet de l'invention.
  • La Fig. 1 est une vue en perspective montrant un exemple de réalisation d'un implant conforme à l'invention.
  • La Fig. 2 est une vue en coupe élévation montrant l'implant vertébral dans une position de blocage.
  • La Fig. 3 est une vue partielle en coupe élévation montrant l'implant en position de libre coulissement des éléments entre eux.
  • La Fig. 4 est une vue en perspective et en partie arrachée montrant des détails caractéristiques de l'objet de l'invention.
  • La Fig. 5 est une vue en coupe élévation d'une caractéristique préférée de réalisation équipant un implant vertébral conforme à l'invention.
  • Tel que cela ressort plus précisément des Fig. 1 à 4 , l'objet de l'invention concerne un implant de remplacement vertébral 1 comportant un premier élément longitudinal creux dit mâle 2 et un deuxième élément longitudinal creux dit femelle 3. Chaque élément 2, 3 comporte respectivement un corps 21, 31 de forme générale tubulaire s'étendant selon un axe longitudinal X. Le corps mâle 21 est adapté pour être engagé partiellement à l'intérieur du corps femelle 31 de manière à s'étendre coaxialement l'un à l'autre. Le corps mâle 21 possède une enveloppe externe de section et de forme sensiblement identiques au jeu près, à l'alésage interne délimité par le corps femelle 31. De préférence, les corps mâle 21 et femelle 31 comportent des évidements 4 pour le passage d'un volume d'ancrage osseux.
  • Selon une caractéristique de l'invention, les éléments mâle 2 et femelle 3 sont montés coulissants l'un par rapport à l'autre selon leur axe commun longitudinal X. Dans l'exemple illustré, le montage coulissant entre les éléments mâle 2 et femelle 3 est réalisé par l'intermédiaire d'une butée de guidage 5 équipant l'élément mâle 2 et engagée dans une lumière ouverte 6 aménagée sur l'élément femelle 3 selon une direction longitudinale parallèle à l'axe longitudinal X.
  • Selon une caractéristique de l'invention, l'implant de remplacement 1 comporte des moyens 8 assurant d'une part, le coulissement libre des éléments 2, 3 entre eux et d'autre part, leur blocage relatif. Ces moyens de blocage 8 comportent sur l'un des éléments à savoir l'élément femelle 3 dans l'exemple illustré, une surface d'ancrage 10 aménagée sur une partie longitudinale 11 de la paroi. Cette surface d'ancrage 10 s'étend à l'intérieur de la paroi de l'élément femelle 3 en vis-à-vis d'un patin d'ancrage 12 monté sur l'autre élément à savoir l'élément mâle 2 dans l'exemple illustré. Le patin d'ancrage 12 est guidé en translation pour occuper une première position dans laquelle les éléments mâle 2 et femelle 3 peuvent coulisser librement entre eux ( Fig. 3 ) et une deuxième position dans laquelle le patin d'ancrage 12 coopère avec la surface d'ancrage 10 pour bloquer en position les éléments 2, 3 entre eux ( Fig. 2 ). A cet effet, le patin d'ancrage 12 comporte sur sa face transversale s'étendant perpendiculairement à la direction de translation du patin, une forme d'ancrage complémentaire ou conjuguée à la surface d'ancrage 10 de manière qu'en coopération mutuelle, les éléments 2, 3 se trouvent verrouillés en position. Par exemple, le patin d'ancrage 12 et la surface d'ancrage 10 présentent des dents s'étendant transversalement par rapport à la direction de coulissement du patin d'ancrage 12.
  • Selon une autre caractéristique de l'invention, les moyens de blocage 8 comportent également un système 15 de transformation d'un mouvement de rotation en un mouvement de translation qui est transmis au patin d'ancrage 12 de manière qu'il occupe sa position dégagée ou sa position de coopération avec la surface d'ancrage 10. Le système de transformation 15 est équipé d'un moyen 16 de réception d'un instrument non représenté, adapté pour commander en rotation le système 15 selon les deux sens opposés. Ainsi, en fonction du sens de commande en rotation imposé par l'instrument de commande, le patin d'ancrage 12 est apte à occuper une de ses deux positions caractéristiques.
  • Dans un exemple préféré de réalisation illustré par les dessins, le système de transformation 15 est du type vis-écrou. Selon cet exemple préféré de réalisation, le système de transformation 15 comporte un axe 17 guidé en rotation et bloqué en translation et monté pour s'étendre diamétralement à l'intérieur de l'élément mâle 2, dans sa partie restant toujours engagée dans l'élément femelle. L'axe 17 comporte une première extrémité 18 de section droite circulaire montée avec jeu, dans un alésage 19 réalisé dans la paroi de l'élément mâle 2. La première extrémité 18 est bordée d'un côté par un épaulement 21 et de l'autre côté par la butée 5. L'axe 17 est ainsi bloqué en translation par la butée 5 et l'épaulement 21, tout en étant guidé en rotation.
  • Avantageusement, la première extrémité 18 de l'axe 17 est pourvue du moyen de réception 16 de l'instrument de commande en rotation de l'axe. Dans l'exemple illustré, le moyen de réception 16 est réalisé par un trou de section prismatique aménagé sur la face transversale délimitant la première extrémité de l'axe 17. Le trou 16 s'ouvre dans la lumière débouchante 6 s'ouvrant sur la face externe de l'élément femelle 3 de manière que le trou 16 puisse être accessible de l'extérieur de l'implant à l'aide d'un instrument de commande tel qu'un tournevis par exemple.
  • L'axe 17 est pourvu d'une partie filetée 25 coopérant avec un taraudage 26 présenté par le patin d'ancrage 12 qui est guidé en translation et bloqué en rotation. Dans l'exemple illustré, la deuxième extrémité 27 de l'axe 17 opposée à la première extrémité 18, est pourvue de la partie filetée 25. Ainsi, tel que cela ressort plus précisément de la Fig. 4 , le patin d'ancrage 12 présente une forme extérieure prismatique montée à l'intérieur d'un alésage 28 de section analogue aménagé dans la paroi de l'élément mâle 2 assurant ainsi un guidage en translation et le blocage en rotation du patin d'ancrage 12. Tel que cela ressort de la description qui précède, la rotation de l'axe 17 dans un sens permet le coulissement du patin d'ancrage 12 pour le rapprocher de la surface d'ancrage 10 tandis que la rotation de l'axe 17 dans un sens opposé conduit à écarter par translation le patin d'ancrage 12 relativement à la surface d'ancrage 10.
  • Selon une autre caractéristique de l'invention, chaque élément mâle 2 et femelle 3 est pourvu d'une paroi d'extrémité 2a, 3a destinée à coopérer avec un plateau vertébral. De préférence, chaque paroi d'extrémité 2a, 3a est pourvue d'un crantage pour favoriser l'ancrage de l'implant sur les plateaux des vertèbres sus et sous jacentes.
  • Selon une variante préférée de réalisation, au moins une paroi d'extrémité, à savoir la paroi d'extrémité 2a portée par l'élément mâle 2 dans l'exemple illustré est équipé d'un système 30 assurant son inclinaison dans le plan sagittal anatomique représenté par la référence S sur les dessins. Selon une caractéristique préférée de réalisation, le système d'inclinaison 30 est du type vis-écrou. Ce système d'inclinaison 30 comporte une tige filetée 31 guidée en rotation et bloquée en translation pour coopérer avec une bague taraudée 32 bloquée en rotation et reliée à la paroi d'extrémité 2a dans l'exemple illustré. Plus précisément, la tige filetée 31 s'étend diamétralement à l'intérieur de l'élément mâle 2 selon une direction parallèle à la direction d'extension de l'axe 17. La tige filetée 31 est pourvue à une extrémité d'une tête 34 traversant par un passage 35 la paroi de l'élément mâle 2. L'autre extrémité de la tige filetée 31 est équipée d'une butée d'arrêt en translation 37. La tige filetée 31 coopère avec la bague taraudée 32 qui est pourvue de part et d'autre de prolongements 321 engagés dans des trous complémentaires aménagés dans des pattes 40 s'étendant à l'équerre à partir de la paroi d'extrémité 2a.
  • Tel que cela ressort plus précisément des Fig. 4 et 5 , la paroi d'extrémité 28 est supportée par un plateau 42 s'étendant à partir du corps de l'élément mâle 2 et délimitant par son rebord supérieur un berceau de guidage en rotation pour la paroi d'extrémité 2a. Ainsi, la paroi d'extrémité 28 présente une face interne convexe apte à coopérer avec le plateau 42 de forme concave.
  • Tel que cela ressort clairement de la comparaison des Fig. 2 et 4 , la rotation de la tige filetée 31 conduit à une translation de la bague taraudée 32 qui impose une rotation de la paroi d'extrémité 2a guidé par le berceau de l'élément mâle 2. La paroi d'extrémité 2a peut ainsi être incliné d'un angle α par exemple de l'ordre de 5°.
  • Selon une caractéristique de l'invention, la tige filetée 31 comporte un moyen de réception 48 d'un instrument de commande accessible de l'extérieur de l'élément mâle 2. Dans l'exemple illustré, le moyen de réception 48 est réalisé par un trou de section prismatique aménagé dans la paroi transversale délimitant la tête 34 de la tige filetée 31. Le trou 48 est donc accessible de l'extérieur de l'élément mâle 2 et se trouve de préférence aligné avec le moyen de réception 16 selon la direction longitudinale. Les moyens de réception 16 et 48 qui occupent une position superposée proche, sont de préférence de forme identique de manière à pouvoir être manoeuvrés par un même instrument de commande tel qu'un tournevis par exemple.
  • Selon une autre caractéristique de l'invention, l'implant intervertébral 1 est adapté pour assurer le déplacement en coulissement de manière simple et efficace des éléments mâle 2 et femelle 3. A cet effet, chaque élément mâle 2 et femelle 3 comporte des zones 50 de préhension pour un appareil de distraction assurant le coulissement relatif entre les éléments mâle 2 et femelle 3. Ces zones de préhension 50 sont réalisées sur chaque élément, par deux méplats s'étendant de façon diamétralement opposée sur les éléments mâle 2 et femelle 3.
  • L'invention n'est pas limitée aux exemples décrits et représentés car diverses modifications peuvent y être apportées sans sortir de son cadre.

Claims (8)

  1. Implant de remplacement vertébral comportant :
    • deux éléments longitudinaux creux dits mâle (2) et femelle (3) montés coulissant l'un par rapport à l'autre selon un axe commun longitudinal (X),
    • et des moyens (8) assurant le blocage et le libre coulissement des éléments entre eux, les moyens de blocage (8) comportant :
    - sur l'un des éléments, une surface d'ancrage (10) aménagée sur une partie longitudinale dudit élément,
    - et sur l'autre des éléments :
    un patin d'ancrage guidé (12) en translation pour occuper une première position dans laquelle les éléments (2, 3) coulissent librement entre eux et une deuxième position dans laquelle le patin d'ancrage (12) coopère avec la surface d'ancrage (10) pour bloquer les éléments (2, 3) entre eux,
    un système (15) de transformation d'un mouvement de rotation en un mouvement de translation transmis au patin d'ancrage (12), le système de transformation de mouvement (15) étant pourvu d'un moyen de réception (16) d'un instrument de commande en rotation selon les deux sens opposés de sorte que le patin d'ancrage (12) occupe une de ses positions en fonction du sens de commande en rotation,
    , caractérisé en ce que le système de transformation est du type vis-écrou (15) et comporte un axe (17) guidé en rotation et bloqué en translation, cet axe (17) étant pourvu d'une partie filetée (25) coopérant avec un taraudage (26) présenté par le patin d'ancrage (12) guidé en translation et bloqué en rotation.
  2. implant de remplacement vertébral selon la revendication 1, caractérisé en ce que l'axe (17) s'étend diamétralement à l'intérieur de l'élément mâle (2) et comporte :
    • une première extrémité (18) pourvue du moyen (16) de réception de l'instrument de commande, cette première extrémité étant guidée en rotation et bloquée en translation dans une paroi de l'élément mâle,
    • une deuxième extrémité (27) munie de la partie filetée (25) coopérant avec le taraudage (26) du patin d'ancrage qui est guidé en translation et bloqué en rotation dans la paroi opposée de l'élément mâle.
  3. Implant de remplacement vertébral selon la revendication 2, caractérisé en ce que le moyen (16) de réception de l'instrument de commande débouche dans une lumière (6) aménagée dans une paroi de l'élément femelle (3) pour être accessible de l'extérieur de l'implant, la paroi de l'élément femelle (3) étant munie intérieurement dans sa partie opposée de celle pourvue de la lumière, de la surface d'ancrage (10).
  4. Implant de remplacement vertébral selon l'une des revendications 1 à 3, caractérisé en ce que chaque élément mâle (2) et femelle (3) est pourvu d'une paroi (2a, 3a) d'extrémité destinée à coopérer avec un plateau vertébral.
  5. Implant de remplacement vertébral selon la revendication 4, caractérisé en ce qu'au moins une paroi d'extrémité (2a, 3a) est équipée d'un système (30) d'inclinaison de la paroi d'extrémité dans le plan sagittal.
  6. Implant de remplacement vertébral selon la revendication 5, caractérisé en ce que le système d'inclinaison (30) est du type vis-écrou et comporte une tige filetée (31) guidée en rotation et bloquée en translation pour coopérer avec une bague taraudée (32) bloquée en rotation et reliée à la paroi d'extrémité guidée en inclinaison.
  7. Implant de remplacement vertébral selon la revendication 6, caractérisé en ce que la tige filetée (31) s'étend diamétralement à l'intérieur d'un élément et comporte un moyen (48) de réception d'un instrument de commande accessible de l'extérieur de l'élément.
  8. Implant de remplacement selon l'une des revendications 1 à 7, caractérisé en ce que chaque élément mâle (2) et femelle (3) comporte des zones de préhension (50) pour un appareil de distraction assurant le coulissement relatif entre les éléments mâle (2) et femelle (3), ces zones de préhension (50) étant réalisées par deux méplats s'étendant de façon diamétralement opposée sur les éléments mâle et femelle.
EP04708377A 2003-02-05 2004-02-05 Implant de remplacement vertebral Expired - Lifetime EP1589906B1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
FR0301339A FR2850563B1 (fr) 2003-02-05 2003-02-05 Implant de remplacement vertebral et appareil de distraction pour la mise en place de l'implant
FR0301339 2003-02-05
PCT/FR2004/000262 WO2004071355A2 (fr) 2003-02-05 2004-02-05 Implant de remplacement vertebral et appareil de distraction pour la mise en place de l'implant

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EP1589906A2 EP1589906A2 (fr) 2005-11-02
EP1589906B1 true EP1589906B1 (fr) 2009-04-22

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EP (1) EP1589906B1 (fr)
DE (1) DE602004020731D1 (fr)
ES (1) ES2325583T3 (fr)
FR (1) FR2850563B1 (fr)
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FR2850563A1 (fr) 2004-08-06
FR2850563B1 (fr) 2005-11-04
WO2004071355A3 (fr) 2004-11-04
US20060200244A1 (en) 2006-09-07
DE602004020731D1 (de) 2009-06-04
ES2325583T3 (es) 2009-09-09
US7819920B2 (en) 2010-10-26
EP1589906A2 (fr) 2005-11-02

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